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Query: UMLS:C0030193 (pain)
 261,466 document(s) hit in 31,850,051 MEDLINE articles (0.00 seconds)

Most forms of therapy for the loin-pain/haematuria syndrome are unsuccessful, though nerve-block procedures and renal denervation sometimes provide temporary relief. Three young patients, with pain so severe that they were dependent on narcotics, were treated for this syndrome. All three had been repeatedly admitted to hospital. Loin pain was unilateral in two patients and predominantly so in the third. Renal function, excretion urography, and angiography were normal, but renal biopsy specimens showed deposition of the third component of complement in the renal arterioles. All were treated with renal autotransplantation; the kidney causing pain (or the one causing the most pain) was completely excised and reimplanted in the iliac fossa. Two patients had complete relief of pain and the third almost complete relief, despite recurrence of haematuria in all three. It is too early to determine whether this major procedure is justified in the treatment of the loin-pain/haematuria syndrome, but the early results are encouraging.
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PMID:Renal autotransplantation for severe loin-pain/haematuria syndrome. 286 94

A syndrome of back and loin pain produced by impingement of the lowest rib against the iliac crest is described in six patients. All had noticed a significant loss of height and five had osteoporosis of the vertebral column. It is suggested that mechanical irritation of the lowest rib against the iliac crest was the cause of the pain and that subperiosteal resection of the outer two-thirds of the rib would stop this irritation and relieve the symptoms. The six patients who underwent resection of the twelfth rib all obtained relief of symptoms; in one patient the eleventh rib also was resected. At latest review 5 to 34 months postoperatively there has been no recurrence of symptoms.
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PMID:Costo-iliac impingement syndrome. 315 43

Cystoscopy, intravenous urography and urine culture frequently fail to reveal the cause of loin pain and haematuria in young women. Two such women are presented in whom renal biopsy was not only unhelpful but also misleading. Subsequent renal arteriography showed arteriovenous fistulae which were considered erroneously to be the cause of the symptoms in both patients; in fact the fistulae were traumatic post-biopsy fistulae rather than congenital malformations. These patients were probably examples of the "loin/pain/haematuria syndrome" which is thought to have a vascular basis and may have predisposed to the formation of fistulae.
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PMID:Loin pain and haematuria in young women: diagnostic pitfalls. 710 78

Fifteen patients with the loin pain and haematuria syndrome (LPH) were compared with 10 patients with complicated renal stone disease referred to the same tertiary centre and matched for age, sex and duration of illness. LPH patients had a history of three times more medically unexplained somatic symptoms other than loin pain (p < 0.01) and a higher proportion took analgesics regularly (p < 0.01). The onset of pain was associated with an adverse psychologically important life-event in eight of the LPH patients but in none of the controls (p < 0.02). LPH patients more frequently recalled serious parental illness and disability in childhood (p < 0.001) than controls, and a higher proportion felt responsible for causing or alleviating parental illness or distress (p < 0.05). LPH subjects scored higher in the 'paternal care' dimension of the Parental Bonding Instrument (p < 0.05). No difference was found between LPH patients and controls in terms of current depression and anxiety but both groups exhibited high rates of lifetime depression. LPH patients expressed lower levels of anger and hostility (p < 0.002) than did controls. Our observations suggest that psychological factors are of major importance in the aetiology of LPH, which may represent a type of somatoform pain disorder.
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PMID:Loin pain and haematuria syndrome: a somatoform disorder. 749 67

A giant aneurysm of the abdominal aorta presented with a 2-3 h history of right loin pain radiating to the groin and was associated with microscopic haematuria. The pain settled and a urogram was performed 2 days later. Considerable calcification in its wall outlined a very large aneurysm of the abdominal aorta with a maximum transverse diameter of 13.5 cm. The patient underwent successful emergency surgery, at which time a right-sided posterolateral rupture of the aneurysm was present. The patient remains alive and well 4 years later.
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PMID:Giant aneurysm of the abdominal aorta. 769 30

Loin pain hematuria syndrome (LPHS) is characterized by hematuria and incapacitating loin pain. The pain experienced with LPHS is, in general, extremely difficult to treat. Many surgical and pharmacologic therapies have been directed at LPHS pain without success. This report documents successful pain control in a patient with LPHS using long-term intrathecal morphine delivered via an implantable pump. Intrathecal narcotic therapy may provide pain relief for the chronic pain of LPHS.
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PMID:Loin pain hematuria syndrome: pain relief with intrathecal morphine. 770 62

We report a case of autotransplantation performed 21 years ago in a patient suffering from intractable loin pain. Long-term followup, the pathogenesis of pain in regard to renal innervation and the value of autotransplantation as a form of complete sensory denervation are discussed.
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PMID:Autotransplantation for intractable loin pain: report of a case with long-term followup. 781 93

The Loin Pain and Haematuria Syndrome is a relatively new diagnosis applied to the problem of persistent loin pain, often with haematuria, in the absence of identifiable explanatory organic pathology. Case reports have suggested a range of salient psychopathological features associated with the complaints of pain and haematuria, although the psychological factors have been largely neglected in understanding the aetiology or in approaches to management. The roles of illness behaviour, patterns of somatisation, and psychiatric disorder associated with chronic pain syndromes, need to be addressed, as do the patterns of medical and surgical response to these patients. The use of the term "syndrome" to describe these symptoms implies a degree of uniformity in clinical features and outcome that has not yet been substantiated. New surgical techniques have been developed such as renal denervation and renal auto-transplantation to treat the pain, with limited success. A review of this condition illustrates the frequent failure of medicine to apply multi-factorial biopsychosocial models to understanding the aetiology and management of unexplained physical symptoms. It also illustrates the failure of our current nosology and understanding of somatoform disorders to achieve application outside psychiatry.
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PMID:Psychiatric issues in the "loin pain and haematuria syndrome". 799 86

We report a case of bilateral consecutive renal autotransplantation for the loin pain/hematuria syndrome. Initial good response was followed by recurrent consecutive pain in the transplanted kidneys, necessitating bilateral graft nephrectomy and renal hemodialysis.
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PMID:Anephric state after graft nephrectomy in a patient treated with renal autotransplantation for bilateral metachronous loin pain/hematuria syndrome. 807 94

Although not a cause of progressive renal damage, loin pain and haematuria syndrome is nevertheless associated with significant morbidity. The management of pain often presents a formidable problem to urologists, physicians and general practitioners. An earlier study noted hold-up of urine in the renal pelvis and implicated this in the pathogenesis of pain. In this study we have failed to demonstrate an excess incidence of disordered urinary peristalsis in loin pain and haematuria syndrome.
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PMID:Ureteric peristalsis studies in loin pain and haematuria syndrome: another diagnostic disappointment. 822 Sep 88


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